Provider Demographics
NPI:1952557274
Name:DAVID SINGLETON MD,PA
Entity Type:Organization
Organization Name:DAVID SINGLETON MD,PA
Other - Org Name:NORTHEAST MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACLILLINE
Authorized Official - Middle Name:F
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-358-0828
Mailing Address - Street 1:9745 FM 1960 BYPASS RD W
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4069
Mailing Address - Country:US
Mailing Address - Phone:281-358-0828
Mailing Address - Fax:281-358-4083
Practice Address - Street 1:9745 FM 1960 BYPASS RD W
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4069
Practice Address - Country:US
Practice Address - Phone:281-358-0828
Practice Address - Fax:281-358-4083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4522208VP0014X, 261QP3300X
TXPA02179363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0026NBOtherBLUECROSSBLUESHEILD
TX00U32LMedicare PIN